近足月小于胎龄儿围生期并发症发生情况和危险因素分析

目的:回顾性分析近足月小于胎龄儿围生期并发症发生情况和危险因素.方法:选择349例近足月儿,其中小于胎龄儿(SGA)187例,适于胎龄儿(AGA)162例,比较2组患儿的围生期情况、出生后一般情况、并发症发生情况、治疗转归和随访预后.结果:SGA组患儿围产期的母亲妊娠期高血压综合征、孕期感染、脐带异常和宫内窘迫的发生率分别为43.32%、11.23%、26.20%和18.72%,均高于AGA组(P<0.05~P<0.01);SGA组患儿胎龄显著小于、1 min Apgar评分显著低于、住院时间显著长于AGA组(P<0.01);SGA组患儿呼吸窘迫综合征、感染、高胆红素血症发生率和静脉营养应用率分别为45.99%、61.50%、32.09%和85.56%,均高于AGA组(P<0.05~P<0.01);SGA组患者出院时并发症痊愈率为56.14%,低于AGA组的70.54%(P<0.05),但随访1年时,2组患儿发育情况差异无统计学意义(P>0.05).结论:SGA较AGA患儿具有更高的并发症发生率和更低的痊愈率,同时母亲妊娠期高血压综合征、孕期感染、脐带异常和宫内窘迫是造成近足月儿SGA的危险因素,临床医生应高度重视SGA的特点,尽早干预其发生的危险因素.

Perinatal complication and its treatment in late preterm infants with small for gestational age

Objective:To analyze the perinatal complications and its treatment in late preterm infants with small for gestational age ( SAG) . Methods:The clinical data of 349 late preterm infants,which included 187 SGA infants and 162 appropriate for gestational age ( AGA) infants,were investigated. The perinatal condition,general condition after birth,complications,treatment outcome and prognosis between two groups were compared. Results:The incidences of perinatal mother pregnancy-induced hypertension syndrome, infection during pregnancy, umbilical cord abnormality and fetal distress in SGA group were 43. 32%, 11. 23%, 26. 20% and 18. 72%, respectively,which was higher than that in AGA group(P<0. 05 to P<0. 01). The gestational age and 1 min Apgar score in SGA group were significantly lower than that in AGA group(P<0. 01),and the hospitalization time in SGA group were significantly longer than that in AGA group(P < 0. 01). The incidences of respiratory distress syndrome(RDS),infection,hyperbilirubinemia,and intravenous nutrition application in SGA group were 45. 99%,61. 50%,32. 09%,and 85. 56%,respectively,whose were higher than those in AGA group(P<0. 05 to P<0. 01). The recovery rate of complication in SGA group(56. 14%) was lower than that in AGA group(70.54%)(P<0.05). The difference of the developmental situation between two groups was not statistically significant(P>0. 05). Conclusions:Compared with the AGA infants,the incidence rate of complication and cure rate in SAG infants were higher and lower,respectively. The mother pregnancy-induced hypertension syndrome,infection during pregnancy,umbilical cord abnormality and fetal distress are the main reasons of late preterm infants with SGA. The clinicians should pay high attentions to the characteristics of SGA,and early intervene the risk factors.